Autonomous endoscopic system and control method therefor

ABSTRACT

An autonomous endoscopic system capable of controlling movement of an endoscope inserted into a protective sheath installed in the body of a patient includes: an endoscope operating device capable of operating a relative position of the endoscope with respect to the protective sheath, a rolling angle of the endoscope, and a bending angle of a bending portion which is located at the end of the endoscope and is bendable; and a control unit for controlling the endoscope operating device, wherein the control unit controls the endoscope operating device on the basis of a driving record of the endoscope.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. patentapplication Ser. No. 17/030,331 filed on Sep. 23, 2020, which is acontinuation of PCT international application No. PCT/KR2019/004453filed on Apr. 12, 2019, and claims priority to Korean patent ApplicationNo. 10-2018-0042794 filed on Apr. 12, 2018, and Korean patentApplication No. 10-2019-0043033 filed on Apr. 12, 2019, the entiredisclosures of which are hereby incorporated by reference.

TECHNICAL FIELD

Embodiments relate to an autonomous endoscopic system and control methodtherefor.

BACKGROUND ART

An endoscope is a medical instrument used to directly investigateinternal organs or the inside of body cavities. The endoscope isdesigned to be inserted into the body to observe an organ with a lesionthat cannot be directly seen without performing surgery or autopsy.There are many types of endoscopes such as, for example, a bronchoscope,an esophagoscope, a gastroscope, a duodenoscope, a proctoscope, acystoscope, a laparoscope, and a ureteroscope.

For example, endoscopic surgery using a ureteroscope is known as themost frequently used, reliable method to remove kidney stones. Indetail, the method is performed in the manner of inserting theureteroscope through the ureter to reach a kidney using radiodiagnosticequipment such as C-arm, fragmenting stones with a laser, and extractingthe stones using a basket. Here, the laser and the basket are insertedthrough a channel inside the ureteroscope.

Meanwhile, the radiodiagnostic equipment should be continuously used tocheck the position of the endoscope in the body. Thus, doctors andpatients are at risk of radiation exposure. In particular, surgery ishighly difficult since a very slender endoscope like a ureteroscope hasa limited degree of freedom (bending 1 DOF), and there may becommunication issues between two operators who need to perform preciseworks together. In addition, the surgery precision may decrease when thearms of an operator are fatigued over time as the operator should holdthe endoscope for a long time. As described above, the endoscopicsurgery requires precision, which results in the high fatigue of theoperator. In addition, since it is impossible to accurately measure thesize of stone using the endoscope alone, there may occur a medicalaccident such as hurting the ureter of a patient in the process ofwithdrawing a stone that is not fragmented sufficiently. If the ureteris damaged, surgery is immediately performed through an incision, andafter that, there may be fatal aftereffects.

In consideration of such issues, there is a need for endoscopicequipment that may reduce the risk of radiation exposure of doctors andpatients, reduce fatigue, and prevent medical accidents.

The above description has been possessed or acquired by the inventor(s)in the course of conceiving the present invention and is not necessarilyan art publicly known before the present application is filed.

DISCLOSURE OF INVENTION Technical Goals

An aspect provides an autonomous endoscopic system and control methodtherefor.

Technical Solutions

According to an aspect, there is provided an autonomous endoscopicsystem capable of controlling movement of an endoscope inserted into aprotective sheath installed in the body of a patient, the autonomousendoscopic system including an endoscope operating device capable ofadjusting a relative position of the endoscope with respect to theprotective sheath, a rolling angle of the endoscope, and a bending angleof a bending portion which is located at the end of the endoscope and isbendable, and a control unit for controlling the endoscope operatingdevice, wherein the control unit may control the endoscope operatingdevice on the basis of a driving record of the endoscope.

The autonomous endoscopic system may further include a sensor forsensing information about the relative position of the endoscope withrespect to the protective sheath, wherein the driving record may includeinformation about a relative movement of the endoscope with respect tothe protective sheath.

The sensor may include a first magnetic body and a second magnetic bodyinstalled on the protective sheath and the endoscope, respectively.

A basket for gripping a stone present inside the body of the patient maybe inserted into the endoscope, and the control unit may control theendoscope operating device such that the endoscope automatically returnsto the site where the endoscope was located at a point in time thebasket completes a gripping operation.

A basket for gripping a stone present inside the body of the patient maybe inserted into the endoscope, and when the basket completes a grippingoperation, the control unit may control the endoscope operating device(a) to withdraw the endoscope from the protective sheath, (b) to releasethe gripped stone by opening the basket, and (c) to cause the endoscopeto re-enter, such that the endoscope automatically returns to the sitewhere the endoscope was located at a point in time the basket completesthe gripping operation.

The driving record may include an operation profile that shows anoperation amount of the endoscope operating device over time from afirst point in time to a second point in time.

The first point in time may be a point in time the end of the endoscopeis located at a particular site with respect to the protective sheath.

The second point in time may be a point in time at which a surgicalinstrument inserted into the endoscope performs a particular work.

At least one of the first point in time and the second point in time maybe an optional point in time to be set by an operator.

The operation amount may include a translation amount of the endoscope,a rolling angle variation of the endoscope, and a bending anglevariation of the endoscope.

The control unit may (a) determine whether there is, between the firstpoint in time and the second point in time, a forward-backward movementinterval during which the endoscope passes a particular position andthen returns again, (b) generate, if there is a forward-backwardmovement interval, a shortened profile by removing an operation amountover time during the forward-backward movement interval from theoperation profile, and (c) control the endoscope operating deviceaccording to the shortened profile.

The control unit may (a) determine whether there is, between the firstpoint in time and the second point in time, a forward-backward movementinterval during which the endoscope passes a particular position andthen returns again, (b) generate, if there is a forward-backwardmovement interval, a corrected profile that includes a rolling anglevariation and a bending angle variation during the forward-backwardmovement interval, that does not include a translation amount during theforward-backward movement interval, and that is performed for a timeshorter than the forward-backward movement interval, (c) generate ashortened profile by replacing an operation amount over time during theforward-backward movement interval in the operation profile with thecorrected profile, and (d) control the endoscope operating deviceaccording to the shortened profile.

The control unit may initialize a pose of the endoscope such that theendoscope has a particular rolling angle and a particular bending anglewhen the end of the endoscope is located at a particular site withrespect to the protective sheath.

The autonomous endoscopic system may further include a display foroutputting an image of the inside of the body of the patient to anoperator, wherein the control unit may display the image by overlaying,on the image, an expected position and pose of the endoscope at a pointin time after a set time elapses from a current time.

The autonomous endoscopic system may further include a clutch operableby an operator and capable of allowing or stopping a continuous drive ofthe endoscope operating device.

The autonomous endoscopic system may further include a master devicelocated at a site spaced apart from the endoscope operating device andoperated by an operator to remotely operate the endoscope operatingdevice.

Effects

According to embodiments, an endoscope may autonomously drive to aparticular position based on kinematic driving records, and thus it ispossible to remarkably reduce the surgery fatigue of an operator.

According to embodiments, particularly in the case of kidney stonesurgery, it is possible to automatically perform repeated works such asrepeatedly inserting and withdrawing an endoscope to withdraw a numberof stone fragments at a particular site one by one.

According to embodiments, particularly in the case of kidney stonesurgery, it is possible to quickly perform work such as repeatedlyaccessing a particular position, which is very difficult due to thecomplex internal structure, based on previous driving records. Further,it is possible to access the particular position along the shortest pathbased on the previous driving records, and thus the operation time maybe considerably reduced. Consequently, the time for general anesthesiaof a patient may be reduced, which may improve the stability of surgery,in particular, for elderly patients. According to the simulationresults, the operation time of 2 hours on average may be reduced to 1hour or less.

BRIEF DESCRIPTION OF DRAWINGS

FIG. 1 illustrates an apparatus for endoscopic surgery according to anembodiment.

FIG. 2 is a block diagram illustrating an autonomous endoscopic systemaccording to an embodiment.

FIG. 3 illustrates a configuration of an autonomous endoscopic systemaccording to an embodiment.

FIG. 4 illustrates an endoscope inserted into the body of a patient.

FIG. 5 illustrates a general procedure of kidney stone removal surgery.

FIG. 6 is a flowchart illustrating a control method for an autonomousendoscopic system according to an embodiment.

FIGS. 7 and 8 illustrate an operation of storing a driving recordaccording to an embodiment.

FIG. 9 illustrates an example of an operation profile represented as agraph showing over time an operation amount of an endoscope operatingdevice operated by an operator during a particular interval.

FIGS. 10 and 11 illustrate an operation of correcting a driving recordaccording to an embodiment.

FIG. 12 illustrates another example of an operation profile representedas a graph showing over time an operation amount of an endoscopeoperating device operated by an operator during a particular interval.

FIG. 13 illustrates an operation of correcting a driving recordaccording to another embodiment.

FIG. 14 illustrates a shortened profile generated by performing anoperation of correcting a driving record according to anotherembodiment.

BEST MODE FOR CARRYING OUT THE INVENTION

Hereinafter, embodiments of the present disclosure will be describedwith reference to the accompanying drawings. Regarding the referencenumerals assigned to the components in the drawings, it should be notedthat the same components will be designated by the same referencenumerals, wherever possible, even though they are shown in differentdrawings. Also, in the description of the embodiments, detaileddescription of well-known related structures or functions will beomitted when it is deemed that such description will cause ambiguousinterpretation of the present disclosure.

Also, in the description of the components, terms such as first, second,A, B, (a), (b) or the like may be used herein when describing componentsof the present disclosure. These terms are used only for the purpose ofdiscriminating one constituent element from another constituent element,and the nature, the sequences, or the orders of the constituent elementsare not limited by the terms. When one constituent element is describedas being “connected”, “coupled”, or “attached” to another constituentelement, it should be understood that one constituent element can beconnected or attached directly to another constituent element, and anintervening constituent element can also be “connected”, “coupled”, or“attached” to the constituent elements.

The same name may be used to describe an element included in theembodiments described above and an element having a common function.Unless otherwise mentioned, the descriptions on the embodiments may beapplicable to the following embodiments and thus, duplicateddescriptions will be omitted for conciseness.

FIG. 1 illustrates an apparatus for endoscopic surgery according to anembodiment.

Referring to FIG. 1, an apparatus for endoscopic surgery 900 may includean endoscope 910 and a surgical instrument 920.

The endoscope 910 may include a control handle 911 to be gripped by anoperator with a hand, an instrument hole 912 configured to guide thesurgical instrument 920, an insertion tube 913 connected to the controlhandle 911 and to be inserted into the body, a bending portion 915located at the end of the insertion tube 913 and configured to perform abendable motion, a knob 914 provided rotatably in the control handle 911and configured to adjust an angle of the bending portion 915 accordingto manipulation, and a magnetic body 916 provided in the insertion tube913. The function of the magnetic body 916 will be described later.

The surgical instrument 920 may include an operation part 921 to begripped with a hand and operated by the operator, a surgical instrumentcable 922 connected to the operation part 921 and to be inserted intothe insertion tube 913 of the endoscope 910, and an action part 923provided at the end of the surgical instrument cable 922 and to beoperated by the operation part 921. The action part 923 may include, forexample, a basket capable of gripping a stone present inside the body ofa patient. Hereinafter, a case where the action part 923 is a basketwill be described as an example. However, differently, the action part923 may be another means known to those skilled in the art, such as alaser lithotripter that fragments stones.

For example, the operation part 921 may include a first operation unit921 b and a second operation unit 921 b, wherein the operation part 921may operate the action part of the surgical instrument 920 by moving thesecond operation unit 921 b, which moves relatively with respect to thefirst operation unit 921 b, toward the first operation unit 921 b.According to the operation of the operation part 921, the action part923 may perform a particular work (for example, operating the basket oroperating the laser lithotripter).

FIG. 2 is a block diagram illustrating an autonomous endoscopic systemaccording to an embodiment, and FIG. 3 illustrates a configuration of anautonomous endoscopic system according to an embodiment.

Referring to FIGS. 2 and 3, an autonomous endoscopic system 1 maycontrol a movement of the endoscope 910 inserted into a protectivesheath 11 or a movement of the surgical instrument 920 inserted throughthe endoscope 910. For example, the autonomous endoscopic system 1 mayinclude an endoscope operating device 12, a control unit 13, a sensor14, a master device 15, an input unit 16, a clutch 17, a radiodiagnosticdevice 18, a display 19, and a radiation shield wall W.

The protective sheath 11 may be placed in the body of the patient toprevent damage to the body of the patient by friction with the endoscope910. The protective sheath 11 includes a protective hole provided in alength direction thereof to guide the endoscope 910.

The endoscope operating device 12 may provide a driving force to drive,roll or bend the endoscope 910, or provide a driving force for thesurgical instrument 920 to perform a particular work. For example, theendoscope operating device 12 may have a structure that is attachable toand detachable from a commercial endoscope and/or a commercial surgicalinstrument. The endoscope operating device 12 may have a structure thatis physically fastenable to each operation part of the commercialendoscope and/or the commercial surgical instrument, and may operate thecommercial endoscope and/or the commercial surgical instrument based ona signal input through the master device 15 by driving the fastenedpart. Meanwhile, instead of using a commercial endoscope and/or acommercial surgical instrument, an endoscope and/or surgical instrumentdedicated to the endoscope operating device 12 may be used, and theendoscope operating device 12 may be formed integrally with theendoscope and/or surgical instrument. The endoscope operating device 12may include a translation operation part 121, a rolling operation part122, a bending operation part 123, and a surgical instrument operationpart 124.

The translation operation part 121 may adjust a relative position of theendoscope 910 with respect to the protective sheath 11. For example, thetranslation operation part 121 may include a driving source configuredto move the entire endoscope 910 forward or backward by moving, along alinear guide rail, a block with the control handle 911 of the endoscope910 mounted.

The rolling operation part 122 may manipulate a rolling angle of theendoscope 910. For example, the rolling operation part 122 may include adriving source configured to rotate, based on an axial direction of theendoscope 910, the block with the control handle 911 of the endoscope910 mounted.

The bending operation part 123 may adjust a bending angle of the bendingportion 915 of the endoscope 910. For example, the bending operationpart 123 may include a driving source configured to pull a wire insertedinto the bending portion 915.

The surgical instrument operation part 124 may include, on the blockwith the control handle 911 of the endoscope 910 mounted, a drive sourceconfigured to relatively move with respect to the block and driveanother block with the surgical instrument 920 mounted.

Meanwhile, the above description is only an example of the endoscopeoperating device 12. As another example, unless otherwise mentioned, anyslave device operable with a master-slave relationship may be used asthe endoscope operating device 12, for example, as in KR 1882093, JP2010-279688, and JP 2007-117394.

The control unit 13 may control the endoscope operating device 12. Thecontrol unit 13 may operate the endoscope 910 and the surgicalinstrument 920 by controlling the endoscope operating device 12 based oncontrol signals input through the sensor 14, the master device 15, theinput unit 16, and/or the clutch 17. The control unit 13 may enable theendoscope 910 to autonomously drive by controlling the endoscopeoperating device 12 based on a driving record of the endoscope 910,which will be described later with reference to FIG. 6, and the like.The driving record may include, for example, information about relativemovements (translation, rolling, and bending) of the endoscope 910 withrespect to the protective sheath 11.

The sensor 14 may sense information about the relative position of theendoscope 910 with respect to the protective sheath 11. The control unit13 may control the endoscope operating device 12 based on theinformation sensed by the sensor 14.

For example, the sensor 14 may include a first magnetic body 111 (seeFIG. 4) and a second magnetic body 916 (see FIG. 1) provided on theprotective sheath 11 and the endoscope 910, respectively. For example,the first magnetic body 111 may be provided at a particular site on theprotective sheath 11, and the second magnetic body 916 may be providedat a particular site on the insertion tube 913. The control unit 13 maysense the relative position of the endoscope 910 with respect to theprotective sheath 11 based on a magnitude of magnetic force actingbetween the first magnetic body 111 and the second magnetic body 916.For example, the first magnetic body 111 may be provided at a positionbiased to one side with respect to a longitudinal center line of theprotective sheath 11. Likewise, the second magnetic body 916 may beprovided at a position biased to one side with respect to a longitudinalcenter line of the insertion tube 913. By the structure described above,the control unit 13 may sense a relative rolling angle of the endoscope910 with respect to the protective sheath 11.

As another example, the sensor 14 may be a displacement sensor connectedbetween the protective sheath 11 and the endoscope 910 to sense a changein relative position.

As still another example, the sensor 14 may sense a translation amount,a rolling angle, a bending angle, and/or an operation of the endoscope910 (for example, whether an operation of gripping a basket isperformed), by sensing the operation amount of the endoscope operatingdevice 12.

In the present application, the sensor 14 may include any means capableof sensing the information about the relative position of the endoscope910 with respect to the protective sheath 11, in addition to the meansexemplarily proposed above. For example, the radiodiagnostic device 18may function as the sensor 14, which will be described later.

The master device 15 may be located at a site spaced apart from theendoscope operating device 12 and operated by an operator to remotelyoperate the endoscope operating device 12. The master device 15 shown inFIG. 3 is only an example, and the type of the master device 15 is notlimited in the scope of the present invention.

The input unit 16 may receive an instruction from an operator andtransmit the instruction to the control unit 13. For example, the inputunit 16 may include a known user interface, such as a keyboard or amouse. The operator may select an interval to store the driving recordof the endoscope 910 through the input unit 16.

The clutch 17 may be operable by the operator, and receive theinstruction from the operator and transmit the instruction to thecontrol unit 13, thereby allowing or stopping a continuous drive of theendoscope operating device 12. For example, the clutch 17 may have afoot pedal structure which allows input of information through a foot,rather than using a hand of a user, as shown in FIG. 3.

The radiodiagnostic device 18 may capture and image the inside of thebody of the patient. The radiodiagnostic device 18 may provide theoperator with the position of the endoscope 910. For example, a C-armmay be utilized as the radiodiagnostic device 18.

By the radiodiagnostic device 18, the position of the protective sheath11 may be easily known. Further, the protective sheath 11 may maintain afixed position inside the body of the patient irrespective of themovement of the endoscope 910, and the protective sheath 11 and theendoscope operating device 12 may remain fixed to each other through afixing tool. By the structure described above, it is possible to collectthe relative position between the protective sheath 11 and the endoscope910 through image processing from an image obtained through theradiodiagnostic device 18, and drive the endoscope 910 based on thecollected information. In other words, when the radiodiagnostic device18 is used, it is possible to operate the endoscope 910 even withoutusing the magnetic bodies 111 and 916 as described above. In detail, thecontrol unit 13 may sense the relative position of the endoscope 910with respect to the protective sheath 11 based on the image obtainedusing the radiodiagnostic device 18. In this regard, the radiodiagnosticdevice 18 may be construed as being included in the sensor 14.

The display 19 may provide the operator with the image of the inside ofthe body of the patient through a camera mounted on the radiodiagnosticdevice 18 and/or the endoscope 910. For example, the operator mayselect, on the display 19 by a screen touch or mouse click, the end ofthe protective sheath 11 and the position of a particular part (forexample, a minor calyx) of the organs of the patient, and the controlunit 13 may extract a relative distance between the two selected pointsand provide the operator with the extracted relative distance.

For example, in an autonomous driving mode, the control unit 13 maydetermine an expected position and pose of the endoscope 910 at a pointin time after a set time elapses from a current time, and display theexpected position and pose through the display 19 by overlaying asemitransparent image of the expected position and pose, on the image ofthe inside of the body of the patient. In this state, the operator mayoperate the clutch 17 to determine whether to continue allowing theautonomous driving of the endoscope 910 without an additional operation,or stop or end the autonomous driving as necessary and directly drivethe endoscope 910 using the master device 15. By the configurationdescribed above, when an error occurs due to aging and a degree ofbending angle of the endoscope 910, the operator may correct the errorby intervening in the adjustment, whereby the stability of surgery mayimprove significantly. Further, the control unit 13 may collect theinformation corrected by the operator intervening in the adjustment anduse the collected information as big data of a deep learning algorithmto reduce driving errors of the endoscope 910.

The radiation shield wall W may be provided between an area where theoperator is located and an area where the patient is located. In otherwords, the radiation shield wall W may be provided between the masterdevice 15 and the endoscope operating device 12 to separate two areas,that is, the area where the operator is located and the area where thepatient is located. By the radiation shield wall (W) described above, itis possible to reduce the risk of radiation exposure by theradiodiagnostic device 18 affecting the operator who performs surgery ona large number of patients.

FIG. 4 illustrates an endoscope inserted into the body of a patient, andFIG. 5 illustrates a general procedure of kidney stone removal surgery.

Referring to FIGS. 4 and 5, a procedure of kidney stone removal surgeryperformed using a ureteroscope is shown. Kidney stones (ks) are mostlylocated in a minor calyx (mc) of the kidney (k). For kidney stoneremoval surgery, the protective sheath 11 is inserted through theurethra (UA) of the patient, passes through the bladder (B) and theureter (U), and is placed such that the end of the protective sheath 11is located at the renal pelvis (rp), the part connected to the ureter(U) of the kidney k. In this state, the endoscope 910 is inserted alongthe protective sheath 11, and the operator may scan for a kidney stone(ks) by operating the endoscope 910 in a state in which the bendingportion of the endoscope 910 passes through the end of the protectivesheath 11 to be located in the vicinity of the renal pelvis (rp).Meanwhile, although FIG. 4 simply illustrates the internal structure ofthe kidney (k), the kidney (k) has a much more complex internalstructure in reality. In addition, there is a problem in that theradioactivity of the radiodiagnostic device 18 needs to be continuouslyused to obtain an image of the movement of the endoscope 910 viewed fromthe third-person point of view. Therefore, a work of finding a kidneystone (ks) is performed through the camera of the endoscope 910 mainlyat the first-person point of view. However, it is impossible to know therolling angle and the bending angle from the image viewed through theendoscope 910 without using other external information, and thus, it isdifficult to determine the directivity. Particularly, a minor calyx (mc)where a kidney stone (ks) is mostly found has a multi-branch structure,and thus, it is not easy to determine a minor calyx (mc) to enter.

Further, once a kidney stone (ks) is found, a process of fragmenting thekidney stone and repeatedly withdrawing a number of fragments of thestone from the body of the patient using the basket 923 (see FIG. 1),together with the endoscope, is required. For example, when a stone witha diameter of 1 cm is deconstructed into pieces with a diameter of 2 mm,a total of 125 repetitive insertion and withdrawal works are required.In other words, the process shown in FIG. 5 should be repeated 125 timesper 1 stone (ks).

In the state in which the stone is fragmented, the endoscope 910 needsto move tens of times along the same path to the same minor calyx (mc)to withdraw the stone fragments, and thus, the fatigue of the operatoris continuously accumulated. In addition, if the operator places, inreality, the endoscope 910 in another minor calyx (mc), rather thanplacing the endoscope 910 at the previous work position in the sameminor calyx (mc), the operation time may increase, or the surgery maynot be performed perfectly.

Meanwhile, since the kidney (k) is a relatively solid organ comparedwith the other organs, the kidney (k) is generally maintained in thesame position during the surgery. Consequently, except the basket job(b) of the procedure shown in FIG. 5, at least one of a total of threeremaining operations: (a) inserting the end of the endoscope 910 to belocated at the renal pelvis (rp); (c) withdrawing the endoscope 910 fromthe body of the patient and the protective sheath 11 while holding astone; and (d) releasing the stone from the withdrawn endoscope 910 byopening the basket, may be performed automatically, which will bedescribed with reference to FIG. 6, and the like. In doing so, it ispossible to reduce the fatigue of the operator and to perform stoneremoval surgery faster and more accurately.

FIG. 6 is a flowchart illustrating a control method for an autonomousendoscopic system according to an embodiment, and FIGS. 7 and 8illustrate an operation of storing a driving record according to anembodiment.

Referring to FIGS. 6 to 8, a control method for the autonomousendoscopic system 1 may be performed as follows. Hereinafter, kidneystone removal surgery will be exemplarily described. However, unlessotherwise described, it is obvious to those skilled in the art that theembodiment may also be applicable to other surgery.

First, in operation S11, the operator may insert the protective sheath11 into the body of the patient. The protective sheath 11 may beinserted to pass through the urethra, the bladder, and the ureter of thepatient such that the end thereof is located in the renal pelvis of thekidney.

In operation S12, the endoscope operating device 12 may translate theendoscope 910 along the inside of the protective sheath 11. Meanwhile,through information sensed by the sensor 14 during the translationmovement of the endoscope 910, the control unit 13 may control theendoscope operating device 12 such that the end of the endoscope 910 islocated at a particular site with respect to the protective sheath 11and/or at a particular rolling angle. This process may be performedregardless of the driving record of the endoscope 910. Operation S12 mayalso be referred to as an initialization operation. For example, thecontrol unit 13 may initialize the pose of the endoscope 910 such thatthe endoscope 910 has a particular rolling angle and a particularbending angle when the end of the endoscope 910 is located at aparticular site with respect to the protective sheath 11. The particularsite may be the renal pelvis from which it is easy for the end of theendoscope 910 to access most of the minor calyces.

In operation S13, the operator may scan for a stone by operating theendoscope 910 using the master device 15. If a stone is found, theoperator may fragment the stone by operating the surgical instrument 920using the master device 15, in operation S14. Thereafter, in operationS15, while the endoscope 910 is maintained at the same position andpose, the operator may replace the surgical instrument 920 such as astone fragmenting tool (for example, a laser lithotripter) with a stonegripping tool (for example, a basket). In operation S16, the operatormay perform the basket job of gripping the stone.

While the operator operates the master device 15, the driving record ofthe endoscope 910 from a first point in time to a second point in timemay be stored, in operation S21. In operation S21, an operation amountof the endoscope 910 operated by the endoscope operating device 12 maybe recorded over time. Such an operation amount over time may bereferred to as an “operation profile”. Meanwhile, the “operation amount”may include a translation amount of the endoscope 910, a rolling anglevariation of the endoscope 910, and a bending angle variation of theendoscope 910. Examples of the operation profile described above areshown in FIGS. 9 and 12.

For example, as shown in FIG. 7, operation S21 of storing the drivingrecord may be performed during an interval between particular events.For example, in operation S21, the control unit 13 may determine whetherthe end of the endoscope 910 is located at a particular site withrespect to the protective sheath 11, based on a signal sensed throughthe sensor 14 (operation S211), and start storing the driving recordfrom a corresponding point in time (operation S212). In addition, thecontrol unit 13 may determine whether the surgical instrument 920 hasperformed a particular work based on the operation amount of theendoscope operating device 12 (operation S213), and end storing thedriving record at a corresponding point in time (operation S214).

As another example, as shown in FIG. 8, operation S21′ of storing thedriving record may be performed during an interval between optionalpoints in time that may be set based on an instruction from theoperator. For example, in operation S21′, the driving record may startto be stored depending on whether a driving record start instruction isinput by the operator through the input unit 16 (operations S211′ andS212), and storing the driving record may be ended depending on whethera driving record end instruction is input by the operator through theinput unit 16 (operations S213′ and S214).

If a stone is gripped in operation S16, the operator may operate themaster device 15 to move the endoscope 910 backward together with thestone, or automatically operate the endoscope operating device 12 bytransmitting, to the control unit 13 through the input unit 16,information indicating that the stone is gripped, thereby withdrawingthe endoscope 910 from the protective sheath 11 in operation S17 andremoving the stone by releasing the stone from the surgical instrument920 in operation S18.

In operation S19, the control unit 13 may receive, from the operator,confirmation regarding whether the stone removal has been completed atthe previous work position at which the basket job has been performed.

If information indicating that there is a stone remaining at theprevious work position is input in operation S19, the control unit 13may automatically cause the endoscope 910 to autonomous drive based onthe existing driving record of the endoscope 910 collected in operationS21, thereby inserting the endoscope 910 again such that the end of theendoscope 910 is located at the same site of the previous work position,in operation S22. As such, operations S16 to S19 and S22 may berepeatedly performed until all the stones are withdrawn from theposition at which the basket has gripped the stones. Through operationS22, the operator does not need to memorize the path that the endoscope910 has passed to reach the previous work position and operate themaster device 15 along the path. Since the operator only needs toperform the basket job (operation S16), the fatigue of surgery may besignificantly reduced. In addition, since there is no trial and errorthat may occur until the operator finds the previous work position, theoperation time may be significantly reduced.

When information indicating that the stone removal has been completed atthe previous work position is input in operation S19, the control unit13 may receive, from the operator, confirmation regarding whether thestone removal has been completed at all work positions, in operationS20.

When information indicating that there is a work position at which thestone removal is yet to be performed is input in operation S20,operation S12 may be performed, and sequentially operation S13 ofscanning for stones may be performed.

FIG. 9 illustrates an example of an operation profile represented as agraph showing over time an operation amount of an endoscope operatingdevice operated by an operator during a particular interval.

FIG. 9 shows a series of operations performed by an operator to move theendoscope 910 to a specific work position, wherein the operator movesthe endoscope 910 forward in an incorrect direction, resulting in theend of the endoscope 910 to pass through a particular position (see theinterval between 2 and 3 seconds), moves the endoscope 910 backwardagain (see the interval between 3 and 4 seconds), and then changes thedirection that the end of the endoscope 910 faces (see the intervalbetween 4 and 6 seconds), and moves the endoscope 910 forward (see theinterval between 6 and 7 seconds).

Such a phenomenon may occur, for example, when the endoscope 910 isstuck in the inner wall of an organ of a patient and receivesresistance. Nevertheless, if the endoscope 910 autonomously drives tothe previous work position through repetition of the same operationusing the operation profile without correction, repeated shocks areapplied to the organ of the patient, which may cause a medical accident.In addition, the trial and error time for the forward and backwardmovements unnecessarily increases the operation time. Thus, embodimentsfor resolving this issue will be described below.

FIGS. 10 and 11 illustrate an operation of correcting a driving recordaccording to an embodiment.

Referring to FIGS. 10 and 11, a control method for the autonomousendoscopic system 1 may further include operation S23 of correcting thedriving record. Operation S23 includes operation S231 of determiningwhether there is a forward-backward movement interval and operation S232of generating a shortened profile. Operation S22 may be performed usingthe shortened profile generated as above (see FIG. 6).

Here, the “forward-backward movement interval” refers to an interval, inthe operation profile, during which the end of the endoscope 910 passesa particular position and returns again, and may be the interval between2 and 4 seconds in FIG. 9.

If the control unit 13 determines that there is a forward-backwardmovement interval between a first point in time and a second point intime in operation S231, the control unit 13 may generate the shortenedprofile by removing the operation amount over time during theforward-backward movement interval (the interval between 2 and 4 secondsin FIG. 9) from the operation profile, in operation S232.

The control unit 13 may control the endoscope operating device 12according to the shortened profile generated as above, therebypreventing a burden to the body of the patient. Further, if the operatorfinds a correct target site after several trials and errors, by omittingthe trials and errors and enabling the endoscope 910 to move directly tothe target site along the shortest path, the operation time may besignificantly reduced.

FIG. 12 illustrates another example of an operation profile representedas a graph showing over time an operation amount of an endoscopeoperating device operated by an operator during a particular interval.

FIG. 12 shows a series of operations performed by an operator to movethe endoscope 910 to a specific work position, wherein the operatormoves the endoscope 910 forward in an incorrect direction, resulting inthe end of the endoscope 910 to pass through a particular position (seethe interval between 2 and 3 seconds), moves the endoscope 910 backwardagain (see the interval between 3 and 4 seconds), and then moves theendoscope 910 forward (see the interval between 4 and 5 seconds). Thedifference from the example of FIG. 9 is in that there are changes in arolling angle and a bending angle. In this example, simply removing theforward-backward movement interval (the interval between 2 and 4seconds) is not sufficient. Thus, an embodiment for resolving this issuewill be described below.

FIG. 13 illustrates an operation of correcting a driving recordaccording to another embodiment, and FIG. 14 illustrates a shortenedprofile generated by performing the operation of correcting a drivingrecord according to another embodiment.

Referring to FIGS. 13 and 14, operation S23′ of correcting the drivingrecord includes operation S231′ of determining whether there is aforward-backward movement interval, operation S232′ of generating acorrected profile, and operation S233′ of generating a shortenedprofile. Operation S22 may be performed using the shortened profilegenerated as above (see FIG. 6).

In operation S232′, the “corrected profile” may be, for example, anoperation amount over time that includes a rolling angle variation and abending angle variation during the forward-backward movement intervaland that does not include a translation amount during theforward-backward movement interval.

In operation S233′, the control unit 13 may generate the shortenedprofile by replacing the operation amount over time during theforward-backward movement interval in the operation profile with thecorrected profile.

By this method, even if the moving direction of the end of the endoscope910 changes during the forward-backward movement interval, the changemay be reflected in the driving record of the endoscope 910, andunnecessary repetition of forward and backward translations during theautonomous driving of the endoscope 910 may be prevented. In addition,as shown in FIG. 14, the corrected profile may be performed at a higherrate of change for a time shorter than the forward-backward movementinterval, thereby further shortening the operation time.

A number of embodiments have been described above. Nevertheless, itshould be understood that various modifications may be made to theseembodiments. For example, suitable results may be achieved if thedescribed techniques are performed in a different order and/or ifcomponents in a described system, architecture, device, or circuit arecombined in a different manner and/or replaced or supplemented by othercomponents or their equivalents.

Accordingly, other implementations are within the scope of the followingclaims.

1. An autonomous endoscopic system capable of controlling movement of anendoscope inserted into a protective sheath installed in the body of apatient, the autonomous endoscopic system comprising: an endoscopeoperating device capable of adjusting a relative position of theendoscope with respect to the protective sheath, a rolling angle of theendoscope, and a bending angle of a bending portion which is located atthe end of the endoscope and is bendable; and a control unit forcontrolling the endoscope operating device, wherein the control unitcontrols the endoscope operating device on the basis of a driving recordof the endoscope.